Active NPI
Bruce W Baldwin, M.D.
- Family Medicine Physician
- Erie, PA
National Provider Identifier
1114350808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD039896-L
- Practice address
- 5704 Brewster LN
Erie, PA 16505-1110 - Phone
- (814) 450-4876
- NPI assigned
- Aug 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD039896-L | PA | Primary |
Addresses
Primary practice location
5704 Brewster LN
Erie, PA 16505-1110
Mailing address
5704 Brewster LN
Erie, PA 16505-1110
Phone (814) 450-4876
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD039896-L | PA | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1376611200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1376611200000",
"number": "1114350808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5704 BREWSTER LN",
"city": "ERIE",
"state": "PA",
"postal_code": "165051110",
"telephone_number": "814-450-4876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5704 BREWSTER LN",
"city": "ERIE",
"state": "PA",
"postal_code": "165051110",
"telephone_number": "814-450-4876"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BALDWIN",
"first_name": "BRUCE",
"middle_name": "W",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-08-16",
"last_updated": "2013-08-16",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "PA",
"license": "MD039896-L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Erie, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.